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Monday, June 20, 2016

Crowd Sourcing Contraceptive Advice?

When it comes to contraception we have a long history of asking girlfriends, sisters, hair dressers, and generally getting the broad strokes of over view of contraception alternatives from women's magazines. Now the social media savvy among us have all sorts of options for contraceptive advice from googling medical society guidelines, to reading published research, and getting the spin from the companies that produce contraceptives, themselves. We have had access to contraceptive specialists, gynecologic specialists, and even reproductive endocrinologists for many years now; all of whom have very detailed knowledge of the risks and benefits, and even costs and availability of contraception. When the morning after pill technology was no more than a special dosing way to take available oral contraceptive pills there was a special number to call for information and access to a physician. Although over the counter oral contraceptive prescriptions have been available in other countries for many years, they were not available in the US until recently, and now only in a very limited access in the states that allow this. But women have digital and social media access to the nation, and even the world at large, and this has allowed for a new phenomenon to take place: getting a contraceptive medical consultation and prescription via app as reported on the front page of the New York Times today. I think that Crowd Sourcing is excellent to raise some cash, but do you really want to make this a remote service. Like a remote hug, it may make you smile, but it's not a hug. Many of these contraception app services are available, and you may want to check with your physician, as many of them (Women's Health Practice included) will also offer medical visits by phone depending on condition and whether you are a new or established patient. I would caution women about getting care from a random service provider in various circumstances, here are just a few of the issues you should consider:
1. Have you had medical issues with contraception before?
2. Do you know what medications/contraception your plan covers, help make cost effective decisions
3. Are you aware of the non-contraceptive benefits of pills, often the focus is on contraception, but in truth there are a variety of gynecologic conditions to consider
4. What is your access to a provider you have spoken to before? If you cannot get the same provider, then each time you will be starting over with your medical history
5. Do you have a reproductive life plan? When are you having children? What are the fertility aspects of your contraception going to be?
6. Most gynecologists think that effectiveness and safety is enhanced with long acting contraceptive methods, and most of those (IUDs, injections like DMPA and Nexplanon) require an in person exam, consultation and administration of the method.
7. Are you on other medication? Contraceptives may interact with other medication, and often it's best to have your provider be able to access records, communicate with your primary physician, and or see you if there is adjustment to medications or an development in your medical issues, this also cannot be handled by remote access with just on line access.

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